Insurance Billing Specialist-1.0 FTE

Insurance Billing Specialist

Osceola Medical Center is committed to implementing behavior standards as a foundation for how we hire, develop, and retain our team members. By intentionally selecting candidates whose values and behaviors align with these standards, we ensure that our mission is lived out every day, creating an environment where patients feel valued, respected, and confident that OMC is the place for all their healthcare needs.

The Insurance Billing Specialist is responsible for submitting and managing insurance claims within the Epic EMR system. This role investigates and resolves claim errors and denials, processes appeals, and identifies billing trends requiring escalation. The Insurance Billing Specialist plays a key role in ensuring accurate, timely reimbursement while supporting hospital and clinic revenue cycle operations.

Work Schedule: Monday Friday; Day Shift

Qualifications

High school diploma or GED required; additional medical billing education preferred.

Experience with hospital, clinic, or CAH/RHC billing.

Knowledge of CPT, ICD-10, HCPCS coding, and claim processing rules.

Proficiency in EPIC EMR system preferred.

Strong organizational, problem-solving, and communication skills.

Responsibilities Include

Submit accurate and timely insurance claims using Epic EMR

Identify and correct billing-related errors preventing claim submission

Investigate and resolve claim denials using billing work queues

Perform payer follow-up as assigned to ensure timely resolution

Process appeals in accordance with federal, state, and payer guidelines

Document all actions taken on claims and appeals within the system

Identify and escalate recurring issues, trends, or payer patterns to the Lead Biller or Billing Manager

Collaborate with internal teams and departments to ensure efficient revenue cycle workflows

Knowledge, Skills, and Abilities

Knowledge of hospital and clinic billing processes, including Medicare, Medicaid, and commercial payer requirements

Understanding of CPT, HCPCS, ICD-10-CM, and revenue codes, as applicable

Familiarity with claims submission, payment posting, denials, adjustments, and appeals processes

Proficiency with electronic medical record and billing systems (Epic or comparable systems)

Strong attention to detail with the ability to maintain accuracy and meet deadlines

Effective written and verbal communication skills

Ability to analyze and resolve billing discrepancies and payer rejections

Ability to manage multiple priorities in a fast-paced healthcare environment

Ability to maintain HIPAA compliance and handle confidential information appropriately

Ability to work independently and collaboratively within revenue cycle and clinical teams

Physical Requirements for the Role

Example: standing for long periods of time, manual dexterity required to manipulate small objects such as a keyboard, etc.

Work Environment

Hybrid office-based environment with the hospital setting and remote at home

Occasional interactions with patients and clinical staff

Standard work hours with occasional overtime as needed.

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.

Behavior-Based Leadership Expectations

Successful candidates will:

Treat every patient, visitor, and team member with dignity and respect

Take ownership of their actions and follow through on commitments

Adapt positively to change and support new initiatives

Contribute to a culture of trust, collaboration, and accountability

Consistently act in ways that support OMC's mission and values

At OMC, we don't just hire for skillswe hire for behaviors that align with our mission. We invest in team members who are committed to making a meaningful difference in the lives of our patients and in the communities we serve.

Osceola Medical Center is an equal opportunity employer and is committed to creating an inclusive environment for all employees.